Case 05(2024): A case of extremely preterm infant with giant placental chorioangioma and thrombocytopenia
10.3760/cma.j.cn113903-20240405-00249
- VernacularTitle:病例05（2024）：超早产儿合并巨大胎盘绒毛膜血管瘤及血小板减少症1例
- Author:
Xiaoqing LI
1
;
Qi ZHANG
;
Jiaoe PAN
;
Hong WEN
Author Information
1. 浙江大学医学院附属妇产科医院产科，杭州 310000
- Keywords:
Placental chorioangioma;
Fetal anemia;
Intrauterine transfusion;
Fetal/neonatal alloimmune thrombocytopenia
- From:
Chinese Journal of Perinatal Medicine
2024;27(10):849-855
- CountryChina
- Language:Chinese
-
Abstract:
This article reports a case diagnosed with a large placental chorioangioma during the mid-trimester of pregnancy. The condition of this case progressed rapidly, with complications of edema, severe anemia, and severe heart failure, presenting a critical condition. After multidisciplinary consultation and discussion, amniotic fluid reduction and intrauterine fetal blood transfusion were performed at 27 weeks and 1 day of gestation to alleviate maternal and fetal symptoms. An emergency cesarean section was performed due to placental abruption 25 h after the operation, delivering an extremely preterm infant. The infant was diagnosed with fetal/newborn alloimmune thrombocytopenia caused by positive anti-human leukocyte antigen (HLA) antibodies after ineffective multiple platelet transfusions within three days after birth. The infant's condition improved after the transfusion of platelets negative for anti-HLA antibodies. This case was complicated by multiple high-risk factors, with an extremely high risk of fetal and postnatal death. Successful rescue through multidisciplinary collaboration was achieved, and both mother and child recovered well after the operation. It suggests that in clinical practice, attention should be paid to large chorioangiomas, and regular monitoring of the chorioangioma and fetal intrauterine development is necessary. For fetuses and newborns with thrombocytopenia, especially those with ineffective platelet transfusions, the detection of platelet antibodies should be emphasized, and while considering anti-platelet specific antibodies, the role of HLA antibodies should also be considered.
